1 February 28, 2013 Supportive Housing: What You Need to Know about Getting Started
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Supportive Housing: What You Need to Know about Getting Started
February 28. 2013
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Partnership with CSH
• Joint effort to strengthen common and collective efforts to end the cycle of homelessness and incarceration in county jails through placement in affordable housing with the necessary supports to stabilize and thrive in the community.
For more information about NACo’s Criminal Justice Programs and to view the recorded webinar, please visit:
http://www.naco.org/programs/csd/Pages/Justice.aspx.
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Today’s Speakers: Kim Keaton Senior Program Manager, Government Affairs & Innovations CSH Stacy Lowry Director Mecklenburg County Community Support Services Department Mecklenburg County, NC Erin Porterfield
Executive Director Metro Area Continuum of Care for the Homeless (MACCH) Collaborating Center Douglas County, NE
The Source for Housing Solutions
Supportive Housing for Frequent Users of the Homeless and Criminal Justice Systems
NACo & CSH Working Group Call, Feb. 28, 2013
About CSH
CSH is a national non-profit organization that advances solutions that use housing as a platform
for services to improve the lives of the most vulnerable people, maximize public resources and
build healthy communities.
We offer capital, expertise, information and innovation that allow our partners to use
supportive housing to achieve stability, strength and success for the people in most need.
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Goal of NACo and CSH County Working Group Collaboration
Increase collaboration and integration of policies and resources among housing, criminal justice and behavioral health agencies
Define the scale and scope of the problem(s) in county communities
Identify and assemble the resources needed to create supportive housing (e.g. rent subsidies, unit set-asides, services funding)
The Source for Housing Solutions CSH’s Frequent User
Systems Engagement (FUSE) Initiative
Why We Do It: Lavelle’s Story
Lavelle has been arrested more than 150 times, largely for quality-of-life crimes
He suffers from schizophrenia, depression, and drug addiction
Has had inconsistent mental health care and multiple encounters with drug treatment programs
He has spent most of the last 12 years on a revolving door between streets, shelter, hospitals, and jail
What is FUSE?
Thousands of people with chronic health conditions cycle in and out of jails, diversion courts, and homelessness - at great public expense and with limited positive human outcomes.
Many, and some cases all, these costs are borne by Counties
Targeted supportive housing for this most vulnerable and costly of
this group can reduce costs while getting better outcomes
By finding a solution to the frequent user issue, the FUSE program serves as a catalyst for system change
Frequent User Systems Engagement: A CSH Signature Initiative
FUSE Benefits
By providing frequent systems users with stable, supportive housing the following outcomes can occur: Decreased county jail usage (and cost offsets)
Decreased shelter usage (and cost offsets) Decreased use of other county funded systems, like
emergency rooms, detox, hospitals Increased quality of life Leveraging state and federal funds to create a new
pathway – housing – for needier users of county jail services
The FUSE Blueprint: 3 Pillars, 9 Steps
Data-Driven Problem-Solving
Cross-system data match to identify
frequent users
Track implementation progress
Measure outcomes/impact and
cost-effectiveness
Policy and Systems Reform
Convene interagency and multi-sector working group
Troubleshoot barriers to housing placement
and retention
Enlist policymakers to bring FUSE to scale
Targeted Housing and Services
Create supportive housing and develop assertive recruitment
process
Recruit and place clients into housing,
and stabilize with services
Expand model and house additional
clients
The Beginning: New York City FUSE
Demonstration program designed to test whether supportive housing with enhanced engagement services can break cycle of homelessness and incarceration among individuals who are known “frequent flyers” of jail and shelter
Supportive housing with “front-loaded” intensive case management services for 190 frequent users of jail and shelter, identified through pre-generated data match
Frequent User Case Study
DHS DOC DHS DOC DHS DOC DHS DOC DHS DOC DOC DHS DOC DHS DOC DHS DOC DHS 1-Jan-01
15-Jan-01
26-Jan-01
3-Feb-01
21-Feb-01
9-Mar-01
22-Mar-01
14-Jun-01
18-Jun-01
17-Jul-01
23-Jul-01
4-Aug-01
7-Sep-01
16-Oct-01
12-Nov-01
21-Dec-01
8-Mar-02
9-Mar-02
5-Apr-02
8-Apr-02
31-Dec-02
2-Aug-02
DHS
DOC
Neither System
Cross-System Data Match Provides Recruitment List
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0Q7?240M 1&$F041% 4BN@!0N4 10N01&1? LA8&28&$
29%@1A$G
AN940$@#
L&81!NA8 A2OFAN(1 0187&1?3
NAME CLIENT_ID DOC_LOS DHS_LOS SHELTER DOCFacility
McMahon, A 9862966231 45 98 Mens Shelt EMTC
Keaton, K 9862966248 64 132 Urban Minis BBKC
White, L 2511910236 75 64 Womens Shel RMSC
Rysman, M 7890826000 23 156 Skid Row HT EMTC
FUSE Saves $: Jail-Shelter Cost Offsets from NYC FUSE
DOC DHS
FUSE Comparison FUSE Comparison
Average Days Pre 52.8 45.0 58.2 26.6
Average Days Post 25.0 36.0 4.6 7.0
Average Days Avoided 27.8 9.0 53.6 19.6
% Days Avoided 53% 20% 92% 74%
% Reduction Attributable to FUSE 33% 18%
Days Reduced Attributable to FUSE 17.2 10.7
Per Diem Jail/Shelter Cost $129 $68
Annual Cost Offset Per Person $3,586 $3,645
Adjusted Annual Cost Offset Per Person $2,224 $729
Annual DOC & DHS Cost Offset Per Person $7,231
TOTAL DOC & DHS Cost Offsets for 190 Individuals $1,373,890
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Assertive Recruitment Through Jail, Shelter, Hospital In-Reach
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Courts
Jail/Prison
Street
Hospital
Detox
Alcohol/Drug Treatment
Shelter
Psychiatric Hospital
A Community Approach: Sample County Stakeholders & Roles
Partner Role County Leader – such as county manager or agency with CoC/homeless services oversight
Project lead; provides oversight, coordination, and management of stakeholders; property management; quality assurance; employ case managers to provide housing stability and other services to program participants (not typical role)
County Behavioral Health Services Leverage relationship to services and providers for behavioral health services; review of clinical concerns
County Criminal Justice Services Data matching, program oversight, policy advocacy, service enhancement funding, facilitate shelter in-reach; provide referrals to FUSE case managers
Homeless Shelter(s) Assistance with locating potential program participants, referrals to FUSE case managers, temporary housing while tenant is engaged and housing is located
Housing Authority Can administer vouchers, master lease apartments, provide property management
CSH Technical assistance around program design and implementation, training and peer learning
University Program evaluation, report on outcomes and impacts
Supportive Housing: What does it look like?
Section 8 Housing Choice Vouchers (or State rental assistance programs) + Mobile Intensive Case Management Services
Unit set-asides in new supportive housing buildings or existing supportive housing with turnover
Providers trained in Motivational Interviewing, navigating criminal justice system, harm reduction, recognizing “symptoms” of incarceration
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Stabilization through Services
Low case manager-to-client ratio (1:10 – 1:15)
Case manager role as “client advocate” and “failure preventer”
Emphasis on reduction of “risky behaviors”
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Non-judgmental, client-centered counseling
Team approach to services delivery
“Systems Change” Through Case Coordination
Monthly implementation monitoring meetings to track recruitment, housing placement, housing retention, and recidivism prevention
Case conference and intervention in cases of re-arrest or re-hospitalization
Wraps “system of care” around tenants with supportive housing provider in central coordinating role
Sites Implementing or Planning FUSE Initiatives
Implementing FUSE Planning FUSE
Mecklenburg Co, NC
Douglas Co, NE
Contact Information
CSH Andy McMahon, Managing Director, Government Affairs & Innovations [email protected]
Kim Keaton, Senior Program Manager, Innovations [email protected]
NACo Maeghan Gilmore, Program Director for Health, Human Services and
Justice [email protected] Meghan Levine, Justice Associate, County Solutions & Innovations [email protected]
The Road to FUSE: Mecklenburg County, North Carolina
Improved diversion efforts
2005-Jail diversion committee formed with stakeholders from justice and community, adopts GAINS Center model
2006-mental health treatment court formed
Better knowledge of MH status and tools
2007-Sheriff’s Office completes Chronic Offender Study documenting mentally ill and homeless in jail
2009-Sheriff’s Office begins screening arrestees for MH issues and launches CIT for law enforcement/detention officers; 2011-technical assistance from GAINS to develop intercept map
Demonstrated effectiveness of supportive housing in County
2008/9-Homeless to Homes Pilot demonstrates results and is presented to BOCC
2010– County partners with local non-profit to provide social workers for Moore Place, a new supportive housing development; 2012-Moore Pl. begins housing chronically homeless identified through Vulnerability Index
Getting Support from County Leaders
In 2012, frequent jail users were identified as part of the County’s Justice Reinvestment Initiative, and dollars were set aside for services and rental subsidy
Previous effort to serve this population had not worked out well. Too few persons served; unrealistic expectations about client engagement in structured supportive services.
Willingness to try again, given the potential for significant savings associated with jail diversion.
Stakeholder Members and Participation
County agencies CSS, CJS, County Manager,
Sheriff’s Office, Police, PSO, MSCO
Non-profit service providers Supportive housing Shelter services Outreach services
Healthcare orgs Behavioral health orgs Housing authority VA
CSS (oversees homeless services in County) is project lead and manages invites and action items
Meetings held in person bi-monthly
Partners signed agreement consenting to participation in the planning process
Topics and necessary attendees co-managed by CSH and CSS
Stakeholders Meeting Structure
FUSE Initiative Timeline Overview
PHASE 1 – INITATIVE DESIGN (Jan/Feb) Regular team meetings Stakeholder identification and outreach Development of an MOU to execute data match Actual data match Decision made to contract out FUSE supportive services Determine housing application, inspection, and approval process
PHASE 2 – IMPLEMENTATION PLANNING (March/April) Peer learning event in Hennepin Co., MN Develop an assertive outreach and recruitment plan Draft FUSE implementation plan Issue RFP for supportive services and award contract Develop partner MOUs
PHASE 3 – TRAINING AND IMPLEMENTATION (May/July) Develop a comprehensive training support plan Begin to outreach and engage FUSE tenants
E R I N P O R T E R F I E L D
M E T R O A R E C O N T I N U U M O F C A R E
F O R T H E H O M E L E S S ( M A C C H )
S E R V I N G T H R E E C O U N T I E S :
D O U G L A S A N D S A R P Y I N N E B R A S K A P O T T A W A T T A M I E C O U N T Y I N I O W A
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Douglas County use of FUSE
Convergence of Initiatives 31
2011: CoC implemented 100,000 Homes Campaign - Steering committee chaired by Douglas County Commissioner Mary Ann Borgeson
2011: Douglas County re-entry Council begun for readiness of Second Chance Act funds – Co-chaired by Douglas County Commissioner Chris Rogers Douglas County Jail identifies itself as the second biggest
“homeless shelter in Nebraska” with at least 120 people at any one time residing in jail from homelessness.
Commissioner Rogers engaged Corporation for Supportive Housing and NACo for Technical Assistance
Metro Omaha/Council Bluffs Area 2012 32
634,233 people three county population 524,861 people in Douglas County
More than 7,333 people were served by our three
county homeless response system (more than 1% of population homeless in a year)
Decreasing Point in Time Count of People Experiencing Chronic Homelessness
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Year # CH # units of PSH dedicated to CH
2009 322 21 2010 300 34 2011 258 43 2012 191 199
Progression of FUSE in Douglas County 34
Began with the 100K Homes Campaign in 2011. Birthed an interdisciplinary team called the Homeless
Review Team modeled after the Community Review Team (implemented with deinstitutionalization for people with mental illness)
Bolstered by Douglas County Re-entry Council for the
Second Chance Act Now, beginning study of 12 month costs prior to permanent
housing compared to 12 months after permanent housing.
CoC Begins 100K Homes Campaign in 2011 35
For more information go to http://100khomes.org/ 100K Homes helped us know who is most vulnerable in our community, by name, to match the right housing and support. Over the couple of years, we used the Vulnerability Index with over 1489 people, just over 923 of whom are most vulnerable. 1176 people said yes to having been in jail or prison.
Homeless Review Team (HRT) 36
HRT Convenes weekly to review list of people most vulnerable and identify progress to housing
Community Alliance leads with members from: Providers from mental health, substance abuse recovery,
homeless shelters, housing and outreach providers. Specific members are: Veterans Administration, Douglas County Jail, Salvation Army, Douglas County General Assistance, Nebraska AIDS Project, Lasting Hope Recovery Center, Lutheran Family Services, Heartland Family Services, Region 6 Behavioral Health, Visiting Nurse Association, Siena Francis Shelter, Stephen Center Shelter, Housing Providers, etc.
289 vulnerable (FUSE) people housed 37
97% of people housed retain housing for 6 months or more. People homeless cycling in and out of jail, ER, shelters from a
couple of years to more than 20 years. Emphasized a housing first model. HRT providers stretch service eligibility criteria to close gaps
and meet needs Worker assigned as the lead for the person but the team took
the responsibility to bring resources together Culture of the group is a collective responsibility to engage
people, and match housing and support
CoC Program NOFA 38
Landmark new permanent supportive housing project initiated by Douglas County Housing Authority and Douglas County Community Mental Health
CSH assisted us by facilitating project development meetings and clarifying project components to move forward continued to help us focus on program components that are
best fit for highly vulnerable FUSE people when we had a tendency to veer off course to lower need populations
Douglas County Re-entry Council 39
Pursuing strategies to increase housing and support options for FUSE within housing and service subcommittees
100K Homes Cost study 40
Dr. Shinobu Watanabe-Galloway, University of Nebraska College of Public Health is conducting a cost study to compare costs pre and post housing for 150 people most vulnerable and housed through HRT
Data for service costs of shelter, jail, ER, healthcare costs gathered for two periods - 12 month prior and 12 month post housing with client permission.
We are confident that study results (ready in the fall) will show housing is cost effective for people cycling jail, ER, streets, shelter.
Conclusion 41
Our FUSE effort began with a convergence of initiatives prompted by understanding the people through 100K Homes and subsequent Homeless Review Team
The Douglas County Re-entry Council responded to convene entities with resources and interest to serve this population.
Dr. Watanabe-Galloway responded to the need to study the cost effectiveness of our work for this population
Recommendations 42
Start where you can, even if it is with only a few stakeholders
Quantify need with partners. Stick to the vision of serving this group of people with a
Housing First mind set (we began to call it, “Housing Right”)
Link with the 100K Homes Campaign who offers support, ideas, concrete steps forward, cheerleading...
Engage support from Corporation for Supportive Housing – tools, ideas, examples, cheerleading…
Communicate your small successes and successes of other communities.
Erin Porterfield, MACCH 43
[email protected] 402 332-8948 www.MACCHomeless.com 115 S. 49 Ave. Omaha, NE 68132
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Question & Answer Session Instructions
• Type your question into the questions box at any time during the presentation, and the moderator will read the question on your behalf during the Q&A session.
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Thank you for participating in NACo’s webinar.
For more information about
NACo’s Criminal Justice programs, visit: http://www.naco.org/programs/csd/Pages/Justice.aspx
For more information about
CSH, visit: http://www.csh.org
With any questions about this webinar, please contact:
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